P1192 - Understanding the Role of Obesity in Alcoholic Hepatitis: Findings from a National Cohort

Ali Jaan, MD¹, Mostafa Najim, MD², Ashish Dhawan, MBBS³, Umer Farooq, MD⁴, Laraib Fatima. Sheikh, ⁵, Sushil Ahlawat, MD, MS, MBBS^6
1Rochester General Hospital, Rochester, NY; ²Unity Hospital, Rochester, NY; ³Gian Sagar Medical College and Hospital, Chandigarh, Chandigarh, India; ⁴SSM Health Saint Louis University Hospital, St. Louis, MO; ⁵Lahore Medical and Dental College, Rochester, NY; ⁶SUNY Downstate Health Sciences University, Brooklyn, NY

Introduction: Alcoholic hepatitis (AH) represents a severe manifestation of alcoholic liver disease characterized by acute-onset inflammation and liver dysfunction. It presents a wide severity spectrum, from self-limiting disease to severe cases associated with a high mortality risk. With the increasing prevalence of obesity and its known association with liver-related complications, this study aims to investigate the influence of obesity on the severity and outcomes of AH.

Methods: Using the National Readmission Database (NRD) 2016-2020, we employed the International Classification of Diseases, 10th revision, Clinical Modifications (ICD-10-CM) codes to identify adult patients admitted with AH. We further classified AH patients based on the presence and degree of obesity as non-obese (body mass index (BMI) < 30), obese (BMI 30-39), morbidly obese (BMI 40-49) and super-morbidly obese (BMI ≥ 50). Using a multivariate regression model, we compared the outcomes of AH hospitalizations. STATA 14.2 was utilized for statistical analysis.

Results: We included 82,367 AH patients, of whom 5,533 (6.71%) were obese, 2,606 (3.16%) had morbid obesity, and 633 (0.77%) had super morbid obesity (Table 1). When compared to non-obese patients, we observed significantly elevated odds of mortality in both morbidly obese and super-morbidly obese subgroups (adjusted odds ratios (aOR) 1.62 & 2.23 respectively, P< 0.01). Patients with a BMI > 40 had higher odds of complications, including septic shock and intensive care unit (ICU) admission (P< 0.01). Additionally, AH-specific complication, i.e., hepatorenal syndrome (HRS), exhibited elevated odds for all levels of obesity. No statistically significant difference was observed in the odds of spontaneous bacterial peritonitis or variceal upper gastrointestinal bleeding. Resource utilization also demonstrated a progressive increase with increasing severity of obesity (P≤0.03).

Discussion: Our study underscores the increased susceptibility of individuals with AH and a BMI exceeding 40 to heightened mortality risk and complications such as septic shock and ICU admission. The likelihood of HRS and the utilization of hospital resources escalates in tandem with the severity of obesity. Further research is crucial for a comprehensive understanding of the intricate impact of obesity on AH severity and outcomes. This knowledge will inform better clinical management and resource allocation across diverse healthcare settings.


Disclosures:


Ali Jaan, MD¹, Mostafa Najim, MD², Ashish Dhawan, MBBS³, Umer Farooq, MD⁴, Laraib Fatima. Sheikh, ⁵, Sushil Ahlawat, MD, MS, MBBS⁶. P1192 - Understanding the Role of Obesity in Alcoholic Hepatitis: Findings from a National Cohort, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.